18F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography in muscle-invasive bladder cancer

Purpose of review In this narrative review, we assessed the role of 18F-fluoro-2-deoxy-D-glucose-positron emission tomography/CT (FDG-PET/CT) in preoperative staging and response evaluation of neoadjuvant chemotherapy in muscle-invasive bladder carcinoma (MIBC), and to assess its incremental value to contrast-enhanced (CE)CT and MRI in terms of patient management at initial diagnosis and detection of recurrence. Recent findings A literature search in PubMed yielded 46 original reports, of which 15 compared FDG-PET/CT with CECT and one with MRI. For primary tumor assessment, FDG-PET/CT proved not accurate enough (13 reports; n = 7–70). For lymph node assessment, sensitivity of FDG-PET/CT is superior to CT with comparable specificity in 19 studies (n = 15–233). For detection of distant metastases, data from eight studies (n = 43–79) suggests that FDG-PET/CT is accurate, although comparative studies are lacking. Limited evidence (four studies, n = 19–50) suggests that FDG-PET/CT is not accurate for response evaluation of neoadjuvant chemotherapy. FDG-PET/CT incited change(s) in patient management in 18–68% of patients (five reports; n = 57–103). For detection of recurrence, seven studies (n = 29–287) indicated that FDG-PET/CT is accurate. Summary Most studies evaluated FDG-PET/CT for lymph node assessment and reported higher sensitivity than CT, with comparable specificity. FDG-PET/CT showed incremental value to CECT for recurrence a...
Source: Current Opinion in Urology - Category: Urology & Nephrology Tags: PET IMAGING IN UROLOGY: Edited by Stefano Fanti and Declan G. Murphy Source Type: research